Chapter 1 Flashcards
The most significant publication about family nursing…
The Family Nurse: Frameworks for Practice
It is most important for nurses to assess the ______ of illness on the family and the influence of ________ __________ on the ______, _______, and _____ of illness.
Impact
Family Interaction
Cause, Course & Cure
Boldest and most ambitious study by the WHO
FHN
Family Health Nurse Multinational Study
Providing education on family assessment and interventions facilitates the transition from thinking in an ____________ manner to thinking __________ , thus thinking family.
Individualistic
Interactionally
Use of a family assessment framework assists in 2 ways:
Organizing massive amount of data
Provide a focus for intervention
T/F Nurses who embrace belief that illness needs to be treated as a family affair can more efficiently lean the knowledge and clinical skills required to conduct family interviews.
TRUE
The reciprocal relationship between nurses and families is also a significant component of both: (2)
Softening suffering
Enhancing healing
T/F No one assessment model explains all family phenomena.
TRUE
The CFAM is a multidimensional framework consisting of three major categories (3)
Structural
Developmental
Functional
CFAM is based on a theory foundation involving (4)
Systems
Cybernetics
Change
Communication
Indications for family assessment include experiencing emotional, physical or spiritual suffering caused by (2)
Family Crisis
Developmental Milestone
Other indications for assessment include (2) when the family defines or identifies…
Defines an illness or problem as family issue
Identifies a child or adolescent as having diff.
2 other indications for assessment include when a family member or child are being…
Admitted to hospital for psych/MH trtmt (family)
Child admitted to hospital
Another indication for family assessment is when the family is experiencing…
Issues that jeopardize family relationships
Contraindications for family assessment include (2)
Compromises individuation of a family member
Context permits little or no leverage
T/F Conducting a family assessment absolves nurses from assessing serious risks such as suicide, homicide or serious illness.
FALSE
In initially engaging with clients nurses must explicitly present…
The rational for family asessment
The identification of a patient’s problems that a nurse can treat
Nursing Diagnosis
Wright & Leahy believe a nursing dx consist of:
List of family strengths & problems
Any treatment based upon clinical judgment that a nurse performs to enhance patient outcomes.
Nursing Interventions
W&L list of strengths and problem is viewed as…
Not the ‘truth’ but the opinion from one persons perspective
Wright & Bell believe an intervention usually implies a…
One time act w/ clear boundaries, frequently offering or doing something to someone else
Interventions are linear. T/F
Not linear, circular! Not just the first thing you do but the responses as well
Interventions also include an action or response of clinician including:
They occur in:
In order to:
Most importantly, the clinician is _______ accountable.
- including clinician actions, responses
- occurs in therapeutic relationship
- to effect client functioning
- clinician is accountable
All nursing interventions are…
Interactional
The intent of interventions is to..
Effect change
Effective interventions are those that occur because of the “fit” the -
Meshing of intervention and biopsychosocial-spiritual structure of family
Interventions begin with…most important in working with families
Engagement
What is ‘real’ to nurses is a direct consequence of their..
Construction of the world - as it is with families
In order to change the ‘reality’ of families we must..
Assist in developing new ways of interacting within their reality
We do this by using interventions that focus on the:
Behavioural
Cognitive
Affective domains
Behaviours change when _______ change
Perceptions
In research it is shown that when persons engage in individual, marital & family counselling…
There is a significant redux in use of HC services
After assessment a nurse must decide if intervention is necessary.
These are all indications in RT illness: (5)
- Member’s illness has impact on other members
- Child develops problem in context of member’s illness
- Illness is first diagnosed in a family member
- Marked deterioration in a member’s condition
- Chronically ill member returns to community
- Chronically ill patient dies
Other indications for intervention include: (3)
MOI
Members contribute to individual symptoms
One member’s improvement leads to deterioration in another
Important milestone missed or delayed
Contraindications for intervention include (2)
- All members do not wish to pursue
* Members would prefer to work with another professional
Interventions with families include:
5 - Family SPIIM
- Family support
- Family process maintenance
- Family integrity promotion
- Family involvement
- Family mobilization
Other interventions include (CSP)
- Caregiver support
- Sibling support
- Parent education
Two stages of the therapeutic change process:
Creating the circumstances for change
Moving beyond and overcoming problems
In creating circumstance for change we (2)
Bring family together to engage in new convos
Establish ther relationship
In moving beyond & overcoming w (4)
InPP
Invite meaningful convo
Notice & distinguish strengths/resources
Pay careful attention to/explore concerns
Put illness & problems in place!
The three levels of practice:
• Family as context: undergrad focus
• Family as client: family systems nursing
○ grad focus
• Family Therapy: a distinct discipline
In addition to the CFAM we have the
CFIM
-resilience & strength-based, collaborative non-hierarchical model
The CFIM is rooted in notions of:
Postmodernism & BoC
Nursing practice with families is directed by whether the concept of family is viewed as..
Family as context
Family as client
